Individual
ANDREW PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3110 GRANT AVE, PHILADELPHIA, PA 19114-2542
(215) 464-6600
Mailing address
3110 GRANT AVE, PHILADELPHIA, PA 19114-2542
(215) 464-6600
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC006489
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/20/2013
Last updated
04/26/2017
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